WASHINGTON – An independent investigator found that Veterans Affairs officials glossed over problems pointed out by whistle-blowers — such as improperly cleaned medical instruments or psychiatric patients who go for years without evaluations — by declaring that the problems cause no potential harm to public health or safety.

"The VA, and particularly the VA's Office of the Medical Inspector, has consistently used a 'harmless error' defense, where the department acknowledges problems but claims patient care is unaffected," Carolyn Lerner, who leads the U.S. Office of Special Counsel, wrote in a letter to President Obama on Monday. "This approach has prevented the VA from acknowledging the severity of systemic problems and from taking the necessary steps to provide quality care to veterans."

Lerner wrote that veterans' health and safety had been "unnecessarily put at risk."

For example, at a VA facility in Jackson, Miss., last fall, whistle-blowers detailed improper credentialing of providers, inadequate review of radiology images, unlawful prescriptions for narcotics, non-compliant pharmacy equipment used to make chemotherapy drugs and unsterilized medical equipment, she said. The facility faced a provider shortage and subjected veterans to long wait times for appointments.

Lerner cited a VA investigation into falsified appointments in Fort Collins, Colo., designed to make it look as if patients' wait times were shorter than they were. That investigation concluded there was insufficient data to conclude that the longer wait times resulted in a danger to public safety.

In Brockton, Mass., a psychiatrist detailed neglect in long-term psychiatric patient care. One patient was in the facility for eight years, yet had only one note from a psychiatrist in his medical files. A second patient entered the facility in 2003 but had his first psychiatric exam in 2011.

Despite these findings, VA's medical inspector "failed to acknowledge that the confirmed neglect of residents at the facility had any impact on patient care," Lerner wrote.

The Office of Special Counsel report documents a dozen similar cases, including:

• In Montgomery, Ala., a pulmonologist copied notes rather than write new ones, but VA said it could not substantiate that this endangered patient health.

• In Grand Junction, Colo., the VA found a facility with elevated levels of Legionella bacteria — which causes Legionnaire's disease — because of poor maintenance, but the VA found no substantial danger to public health.

• In Ann Arbor, Mich., untrained employees improperly handled surgical instruments, leading to "unsafe and unsanitary work practices." When VA officials partially substantiated the allegations, the whistle-blower said it was "not clear" whether corrective actions improved the situation. There was no follow-up, Lerner wrote.